Speaker - Marina Cazorla

The measurement of axial length is crucial for managing myopia control, as it provides an objective parameter for precise monitoring of eye growth. Myopia control software and devices generate progression curves that are both interactive and individualized, yielding more accurate assessments of myopia progression. These tools produce charts that facilitate the communication of information to parents. A study by Dr. Kamak (2021) provides insights into expected annual axial length growth based on the age of different demographic groups. The study's light gray lines denote normal emmetropic growth, while dark gray lines indicate the acceptable limits for axial length growth in myopia control. The study delineates three distinct zones: Zone 1 signifies normal growth with no risk and requires only routine checkups; Zone 2 indicates intervention if the growth approaches the zone; and Zone 3 necessitates reevaluating the treatment strategy if growth progresses into the area. Effective management of myopia control demands meticulous consideration and strategic planning.

The selection of myopia treatment involves evaluating patient compliance, frequency of visits, and the effectiveness of various therapeutic options. Treatment strategies to mitigate myopia progression include optical, pharmacological, and emerging therapies. The World Society of Pediatric Ophthalmology and Strabismus updated their consensus on myopia management in 2018 to incorporate recent advancements. Current options include Reduced Commodative Demand (CD) lenses, Highly Atmospheric Lenses (HAL) or Defocus Incorporated Multiple Segments (DIMS) lenses, and diffusion optical technology lenses designed to modulate retinal contrast. While these lenses have demonstrated promising results, further study is needed to confirm their long-term efficacy. Proper lens fitting, regular monitoring, and patient education are critical to enhancing treatment outcomes. Soft contact lenses engineered for myopia control, particularly those with dual-focus designs, tend to outperform presbyopia lenses. Orthokeratology lenses also offer effective myopia control; however, they are associated with a higher dropout rate and necessitate meticulous care to prevent infections. Contact lenses generally promote better adherence to treatment protocols. Effective myopia management requires optimal refractive power distribution and stringent monitoring to mitigate infection risks. Ultimately, the treatment choice should be guided by patient adherence, the frequency of follow-up visits, and the therapeutic efficacy of the selected approach.

Studies indicate that atropine is the most effective treatment for myopia, with low doses offering fewer side effects and reduced rebound effects. Nevertheless, it is essential to consider patient eye health and to conduct long-term studies to assess its potential impact on ocular health in adulthood. Emerging therapies, such as combining atropine with other optical interventions, have demonstrated improved effectiveness. Current experimental approaches, including blue and red light therapies, are still undergoing study and require further validation to establish their long-term efficacy and safety. Monitoring axial length is critical to myopia management, with a favorable risk-benefit ratio acceptable. To minimize dropout rates, it is important to tailor treatments to the individual patient's profile and visual needs. Myopia management will likely involve a multifactorial approach integrating established therapies with innovative technologies and promoting visual hygiene practices. 

The inquiry into global myopia trends revealed a significant increase in prevalence across various ethnicities, with the rise closely linked to the use of digital devices. While extensive studies have documented high myopia rates in Asian populations, data from Europe are less comprehensive. A study by Brian Holden and other studies highlight that myopia is markedly more prevalent in Asian populations compared to European and American groups. Managing myopia presents challenges, particularly in regions where social stigma impacts treatment adherence. To address this, healthcare professionals must collaborate more effectively with families and address societal pressures. Proposed strategies include enhancing educational efforts for parents and schools to improve understanding and acceptance of myopia treatment. Academic interventions are crucial, such as training teachers to identify vision issues and educating parents about the long-term effects of untreated myopia. Complementing treatment with lifestyle changes—such as encouraging outdoor activities, maintaining proper posture, and adhering to the 20-20-20 rule—is vital in myopia management. Future approaches should focus on early detection and prevention of myopia, which involves closely monitoring children for early signs of refractive errors and implementing preventative measures to mitigate myopia progression. Frequent follow-ups and early intervention remain essential strategies in managing and preventing the advancement of myopia. 

42nd Congress of the European Society of Cataract and Refractive Surgeons, 6 – 10 September 2024, Fira de Barcelona, Spain.